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04 Understand Why and 06 Ask about suicide
Consider the Underlying Issues Always ask about suicide: ‘have you had thoughts of

ending your life?’ There is no evidence that asking
• Self-harm can help people cope effectively with increases risk. Conversely, talking about suicide may
distress in the short term. But it often plays out in
a habitual need to continue the behaviour. well reduce the risk of suicide and help to reduce
the stigma associated with suicidal feelings. Always
• People self-harm for many reasons, and someone remember to document thoroughly.
who self-harms repeatedly may not always do so
for the same reason each time, or by the same
method.
• It is important to spend time exploring and Have you had
addressing these underlying problems and the thoughts of
function that the self-harm fulfils. Only then can ending your life?
effective support be provided to help recovery.

05 Use the Continuum of Harm
Self-harming behaviour exist on a spectrum from
minimal and occasional harm to more persistent and How are you
serious health harming behaviours. In the same way feeling today?
suicidal behaviour can span minimal and infrequent
thoughts to more persistent and intrusive thoughts
with a clearly formulated plan to die.
The pathway provides a helpful model to understand
the different Categories of Need and a Risks and
Strengths Assessment to help to identify where a
child or young person might be on the continuum of
harm.

The Continuum of Harm

SELF HARM
MORE PERSISTENT AND
MINIMAL AND OCCASIONAL HARM SERIOUS HEALTH HARMING

SUICIDE
MORE PERSISTENT AND
MINIMAL AND INFREQUENT INTRUSIVE THOUGHTS /
THOUGHTS PLAN TO DIE

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